NHS sleep-in pay: what you are owed for sleeping at work

There is no national NHS rate for a sleep-in. The Staff Council guidance says the availability payment should be at least the hours you are expected to be awake multiplied by the minimum wage (or the Agenda for Change minimum hourly rate, whichever your employer chooses locally). Any work you actually do during the night is paid separately, at the appropriate hourly rate.

What counts as a sleep-in

The guidance describes three kinds of on-call availability: at home ready to be called out, at work ready to work, and sleeping in at a workplace. A sleep-in session often includes some wakefulness, some sleep and some work done. The term does not cover staff who are on call at the workplace and can sleep between jobs.

The guidance says sleeping in is most likely in residential care settings. If you work on a ward or in an ambulance station and are simply resting between calls, your arrangement may be a different type of on-call, covered in our guide to NHS on-call pay.

How the minimum is worked out

Under the Working Time Regulations, sleeping in counts as working time. For minimum wage purposes, the guidance says time spent asleep does not count. That is why the minimum availability payment is based on expected wakefulness, not the full length of the session.

The guidance gives a worked example, and it uses hours only. Say a session includes:

• 1 hour of work
• 3 hours of wakefulness
• 7 hours of sleep
• 1 further hour of wakefulness

The minimum availability calculation is 4 hours (3 plus 1) multiplied by the National Minimum Wage or the Agenda for Change minimum hourly rate. The 1 hour of work is then paid on top at the relevant hourly rate. The 7 hours of sleep do not add to the minimum.

The figure is a minimum, and local partnerships can agree more. Options include a flat rate per night, a rate by band or a percentage of salary, which are the options the on-call guidance lists for availability payments generally.

Work done during the night

If you are woken and have to deal with something, that time is work. The guidance says it is paid as work done at the appropriate hourly rate under the handbook. You can also ask for time off in lieu (TOIL) instead of payment for work done, and the guidance says that choice has to be genuine.

Unsocial hours payments and on-call payments cannot both be paid for the same hours (paragraph 2.9 of the handbook). Your employer should be able to explain how a night with both an availability payment and some work done is put through payroll.

Rest after a disturbed night

Paragraph 27.14 of the handbook says that where staff are required to sleep in on NHS premises for a specified period, local agreements should be made for compensatory rest. The handbook does not set the length of that rest. Paragraph 27.13 says on-call staff count as working from the time they are required to do work-related activity, while on-call time they can use as their own does not count as working time.

In practice, ask before your first sleep-in how much rest follows a disturbed night, who agrees it and what happens to the next shift if you were up for much of the night.

What to check with your employer

Figures here come from handbook version 63 and the November 2024 Staff Council guidance. Your employer or union rep confirms the local arrangements, and Scotland, Wales and Northern Ireland may have their own on-call documents. Useful questions:

• Is the sleep-in paid as a flat rate, by band or as a percentage of salary?
• How many hours of expected wakefulness is the payment built on, and does the figure meet the minimum above?
• At what rate is work done during the night paid, and is there a minimum payment period?
• Is TOIL offered as a choice for work done?
• What compensatory rest applies, and how is it recorded?
• Does the sleep-in fall on a public holiday? If so, see NHS bank holiday pay.

If the pay looks too low, start with payroll or your manager, then a union rep. ACAS gives free advice on pay disputes. Our guide to NHS shift patterns has more on how overnight working fits into rotas.